{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:50:05Z","timestamp":1789779005036,"version":"4.0.1"},"reference-count":14,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T00:00:00Z","timestamp":1706745600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Natural orifice specimen extraction (NOSE) in left\u2010sided colorectal surgery requires application of the circular stapler anvil to the proximal bowel without exteriorization through an additional abdominal incision. We describe an intracorporeal method to secure the stapler anvil, termed the intracorporeal antimesenteric ancillary trocar (IAAT) technique.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>The ancillary trocar is attached to the stapler anvil before introduction into the abdominal cavity through the anal or vaginal orifice. The colon is incised before the trocar spike is brought out through the antimesenteric surface 3\u20134\u2009cm within the cut edge. A linear stapler is used to seal the bowel end. The ancillary trocar is detached and retrieved via the NOSE conduit. Following the NOSE procedure, a side\u2010to\u2010end colorectal anastomosis is performed with the transanal circular stapler.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ten consecutive patients underwent elective left\u2010sided colorectal resection with IAAT for NOSE (seven transanal, three transvaginal) from January to June 2023. Median age and body mass index were 66 (range 47\u201374)\u2009years and 24.3 (range 17.9\u201330.8)\u2009kg\/m<jats:sup>2<\/jats:sup> respectively. Two (20%) patients underwent sigmoid colectomy for sigmoid volvulus while eight (80%) underwent anterior resection for colorectal cancer. Median operating time, operative blood loss and postoperative length of hospital stay were 170 (range 140\u2013240)\u2009min, 20 (range 10\u201340)\u2009mL and 1 (range 1\u20133)\u2009day respectively. There were no postoperative complications, readmissions or reoperations. Median follow\u2010up duration was 3 (range 1\u20136) months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The IAAT double\u2010stapling side\u2010to\u2010end anastomotic technique is safe and feasible for patients undergoing left\u2010sided colorectal resection with NOSE, resulting in good outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.16884","type":"journal-article","created":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T04:06:13Z","timestamp":1706846773000},"page":"766-771","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Intracorporeal antimesenteric ancillary trocar: an anastomotic technique facilitating natural orifice specimen extraction in left\u2010sided colorectal surgery"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8287-6812","authenticated-orcid":false,"given":"Isaac","family":"Seow\u2010En","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery Singapore General Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2547-5200","authenticated-orcid":false,"given":"Kelvin Kaiwen","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Singapore General Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0771-5063","authenticated-orcid":false,"given":"Emile Kwong\u2010Wei","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Singapore General Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151\u2010020\u201002330\u20106"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423\u2010020\u201001934\u20108"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2021.106196"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/gastro\/goy055"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLE.0000000000001208"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000004180"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000004975"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.5306\/wjco.v13.i10.789"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151\u2010010\u20100660\u20106"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/1553350610371335"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.7602\/jmis.2020.23.4.201"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00595\u2010022\u201002519\u20102"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2020.06.023"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.16671"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.16884","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T04:54:11Z","timestamp":1750136051000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.16884"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2]]},"references-count":14,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1111\/codi.16884"],"URL":"https:\/\/doi.org\/10.1111\/codi.16884","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2]]},"assertion":[{"value":"2023-08-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}